Associated risk factors in the early stage of diabetic retinopathy

Abstract

Background To investigate the retinal capillary density (RCD) of the macula using optical coherence tomography angiography (OCT-A) in type 2 diabetic patients and to further determine the association with risk factors. Methods A total of 212 eyes from 212 subjects were recruited; subjects included diabetics with no retinopathy (NDR, n = 90 eyes), diabetics with mild retinopathy DR (MDR, n = 36 eyes), and healthy participants (Control, n = 86 eyes). All participants underwent OCT-A scanning. RCD was quantified by superficial and deep retinal capillary layers (SRCL and DRCL) from OCT-A images. Results RCD in SRCL and DRCL was lower in NDR ( P < 0.001) as well as in MDR ( P < 0.001) when compared with control eyes. Diabetic patients were subdivided according to individual risk factors, complications related to diabetes, and hyperglycemia. Diabetic patients showed lower RCD in both the SRCL and DRCL when compared with healthy controls. Diabetics with age > 55y, HbA1c > 7% had significantly reduced DRCL ( P < 0.05) when compared with the other group of diabetics (age < 55y, HbA1c < 7%). Diabetics with a blood urea nitrogen (BUN) > 8.2 mmol/L had significantly reduced SRCL and DRCL when compared to the other group of diabetics. Conclusions Risk factors including older age, higher level of HbA1c, LDL-C and BUN, were associated with lower RCDs found in type 2 diabetic patients with and without mild DR by OCT-A. The impairment of retinal capillary by OCT-A may play a key role in the early monitoring of management in diabetes.

Clinical and Molecular-Genetic Insights into the Role of Oxidative Stress in Diabetic Retinopathy: Antioxidant Strategies and Future Avenues

“…In addition, the mean T2DM lastingness at 38-months follow-up was 15 (3) years in −DR patients vs. 22 (5) years for the +DR patients. Nevertheless, additional factors also play critical roles in managing DR at any stage [1][2][3][4][5][6]19,[26][27][28], with a special interest in diabetics without clinically detectable retinopathy and those suffering from the early DR stage [37,38]. When corrected, these data for multiple testing, significantly lowered SLC23A2 gene expression (fold change) in the T2DM vs.…”

“…From a clinical viewpoint, retinal microvascular changes found in the NPDR eyes are related to basement membranes thickening, pericyte loss, capillary occlusion, and microaneurysms, that can progress towards ischemia, macular edema, and neovascularization [ 4 , 5 , 19 , 36 , 37 , 38 ]. In this context, image analysis of retinal lesions can provide qualitative and quantitative data to accurately diagnosing and grading DR. Our data suggest relatively lower rates of progression of DR in our cohort during the 38-month follow-up.…”

Application of semiparametric model in modelling diabetic retinopathy among type II diabetic patients

“…For example, Hussain et al [15] show that the risk of diabetic retinopathy was higher for a male patient and a patient with age ≥ 49 years. Tan et al [18] showed that for a patient with mild DR, older age was associated with lower retinal capillary density, while the result in [31] reveal that sex is not a risk factor for being diabetic retinopathy, but they identified age as a strong predictor of diabetic retinopathy.…”

“…A study from Ethiopia reported that, gender, haemoglobin a1c (HbA1c) and hypertension are predictive risk factors of diabetic retinopathy [17]. Some studies have also revealed that the odds of diabetic retinopathy is higher for a patient with higher HbA1c [4,12,15,18], longer duration of diabetes [5,12] and hypertensive patients [4,5,17]. A study based on data from a meta-analysis of seven cohort studies reported that insulin treatment has significant association with diabetic retinopathy in patients with type II diabetes mellitus [13].…”

Efficacy of artificial intelligence-based screening for diabetic retinopathy in type 2 diabetes mellitus patients

“…The reported prevalence of DR varies from 10% to 61% in people with DM in different countries [5]. However, research has shown that reasonable intervention and treatment of DR in the early stage can achieve good results in preventing the development of the disease and significantly reduce the blindness rate [6][7][8].…”